Proton Pump Inhibitor Therapy May Up Fracture Risk in Children

Fracture risk remained higher after adjusting for differences in sex, race, other factors

THURSDAY, April 2, 2020 (HealthDay News) — Proton pump inhibitors (PPIs) taken for acid reflux may lead to an increased risk for fractures in children and adolescents, according to a study published online March 12 in the Journal of Pediatric Gastroenterology and Nutrition.

Nathan Fleishman, M.D., from Children’s Mercy Hospital in Kansas City, Missouri, and colleagues used the Pediatric Hospital Information System database (51 U.S. hospitals; June 2011 through December 2015) to identify and propensity-match pediatric patients (aged 6 months to 15.5 years) exposed and unexposed to PPIs.

The researchers observed a statistically significantly higher rate of fractures among the PPI-exposed group (1.4 versus 1.2 percent). The difference remained statistically significant (adjusted odds ratio, 1.2; 95 percent confidence interval, 1.0 to 1.4; P = 0.017) after adjusting for remaining differences in sex, race, encounter type, payer, and resource intensity after matching. The most common fracture location was the upper extremity, but the PPI cohort was more likely to suffer from lower-extremity, rib, and spinal fractures. This appeared to be a class effect and was not tied to a specific PPI agent.

“Our study highlights the need to limit the use of PPIs to individuals who are clearly benefiting and for the least duration necessary,” a coauthor said in a statement. “Additionally, children who are on these medications long-term warrant ongoing follow up.”